Biomedical monitoring during dynamic stress testing. III - Maximum exercise tolerance - Ergometer.
Maximum exercise tolerance in healthy aircrew members limited by cardiac output
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Maximum exercise tolerance in healthy aircrew members limited by cardiac output
Low carbon dioxide concentration breathing effects on exercise tolerance, discussing aerobic capacity decrement and hypercapnia occurrence
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The effects of increasing artificial gravity exposure on four aspects of physiological fitness are examined in four young men who, prior to exposure, were deconditioned with bed rest and water immersion. The four aspects of physiological fitness are orthostatic tolerance, exercise tolerance, forearm endurance, and maximum strength. Orthostatic tolerance was sharply reduced by deconditioning and was substantially improved by walking in simulated lunar gravity (1/6 g) for 2.5 hours daily for 7 days or by walking in 1/2 g and 1 g for 1 hour daily for 3 days. Exercise tolerance was also sharply reduced by deconditioning but did not significantly improve with increasing g-exposure. Walking in 1 g for 1 hour daily for 3 days raised exercise tolerance only a little above the low produced by deconditioning. Forearm endurance and maximum strength were relatively unaffected by deconditioning and subsequent g-exposure.
Inflight exercise to assess work capacity and physical fitness of Gemini 7 astronauts
These results clearly demonstrate that dynamic leg exercise against the footward force produced by LBNP substantially improves tolerance to LBNP, and that even cyclic ankle flexion without load bearing also increases tolerance. This exercise-induced increase of tolerance was actually an underestimate, because subjects who completed the tolerance test while exercising could have continued for longer periods. Exercise probably increases LBNP tolerance by multiple mechanisms. Tolerance was increased in part by skeletal muscle pumping venous blood from the legs. Rosenhamer and Linnarsson and Rosenhamer also deduced this for subjects cycling during centrifugation, although no measurements of leg volume were made in those studies: they found that male subjects cycling at 98 W could endure 3 Gz centrifugation longer than when they remained relaxed during centrifugation. Skeletal muscle pumping helps maintain cardiac filling pressure by opposing gravity-, centrifugation-, or LBNP-induced accumulation of blood and extravascular fluid in the legs.
The physiological mechanisms that facilitate acute acclimation to heat have not been fully elucidated, but the result is the establishment of a more efficient cardiovascular system to increase heat dissipation via increased sweating that allows the acclimated man to function with a cooler internal environment and to extend his performance. Men in good physical condition with high maximal oxygen uptakes generally acclimate to heat more rapidly and retain it longer than men in poorer condition. Also, upon first exposure trained men tolerate exercise in the heat better than untrained men. Both resting in heat and physical training in a cool environment confer only partial acclimation when first exposed to work in the heat. These observations suggest separate additive stimuli of metabolic heat from exercise and environmental heat to increase sweating during the acclimation process. However, the necessity of utilizing physical exercise during acclimation has been questioned. Bradbury et al. (1964) have concluded exercise has no effect on the course of heat acclimation since increased sweating can be induced by merely heating resting subjects. Preliminary evidence suggests there is a direct relationship between the maximal oxygen uptake and the capacity to maintain thermal regulation, particularly through the control of sweating. Since increased sweating is an important mechanism for the development of heat acclimation, and fit men have high sweat rates, it follows that upon initial exposure to exercise in the heat, men with high maximal oxygen uptakes should exhibit less strain than men with lower maximal oxygen uptakes. The purpose of this study was: (1) to determine if men with higher maximal oxygen uptakes exhibit greater tolerance than men with lower oxygen uptakes during early exposure to exercise in the heat, and (2) to investigate further the mechanism of the relationship between sweating and maximal work capacity.
The hypothesis that endurance exercise training designed to increase aerobic capacity results in reduced orthostatic tolerance due to alterations of blood-pressure controlling mechanisms was reexamined using a specially designed training in which tolerance to orthostasis and the primary mechanisms associated with the blood-pressure control could be measured before and after the increase in aerobic capacity. Results demonstrate that maximal oxygen uptake can be significantly elevated in individuals of average fit without reducing lower body negative pressure tolerance. The exercise training was found to cause a resting bradycardia, which had no effect on the cardiac vagal reflex response.
A study to determine the effect of heat acclimation and physical training in temperate conditions on changes in exercise tolerance following water-immersion deconditioning is presented. Five young men were tested on a bicycle ergometer before and after heat acclimation and after water immersion. The subjects and the experimental procedure, heat acclimation and exercise training, water immersion, and exercise tolerance are discussed. Heat acclimation resulted in the usual decreases in exercise heart rate and rectal temperature and an increase in sweat rate. Water immersion resulted in substantial diuresis despite water consumed. The results show that heat acclimation provides an effective method of preventing the adverse effects of water-immersion deconditioning on exercise tolerance.
Cardiovascular system response of Gemini VII ASTRONAUTS to inflight exercise and calibrated workload
The effect of in-flight exercise programs on astronauts' cardiovascular adjustments during spaceflight weightlessness and upon return to Earth was studied. Physiological changes in muscle strength and volume, cardiovascular responses during the application of lower body negative pressure, and metabolic activities during pre-flight and flight tests were made on Skylab crewmembers. The successful completion of the Skylab missions showed that man can perform submaximal and maximal aerobic exercise in the weightless enviroment without detrimental trends in any of the physiologic data. Exercise tolerance during flight was unaffected. It was only after return to Earth that a tolerance decrement was noted. The rapid postflight recovery of orthostatic and exercise tolerance following two of the three Skylab missions appeared to be directly related to total in-flight exercise as well as to the graded, regular program of exercise performed during the postflight debriefing period.
A study measuring the peak oxygen uptake (V02), heart rate (HR), and exercise tolerance time of 15 men of 55 + or - 2 yr and 17 women of 55 + or - 1 yr after 10 days of continuous bed rest (BR) is presented. The experimental conditions and procedures are described. Following BR a decrease in peak VO2 of 8.4 percent in men and 6.8 percent in women, a reduction in exercise tolerance time by 8.1 percent in men and 7.3 percent in women, and an increse in HR of 4.4 percent and 1.3 percent for men and women, respectively, are observed. These data are compared with data from Convertino et al. (1977) for men 21 + or - 1 yr and women 28 + or - 2yr. It is concluded that BR-induced aerobic deconditioning is independent of age and sex, since the relative decrease in peak V02 in the older and younger subjects and men and women are similar.
During the last ten years, two major experiments have elucidated the factors determining acclimatization and tolerance to extreme altitude (over 7000 m). These were the American Medical Research Expedition to Everest, and the low pressure chamber simulation, Operation Everest II. Extreme hyperventilation is one of the most important responses to extreme altitude. Its chief value is that it allows the climber to maintain an alveolar PO2 which keeps the arterial PO2 above dangerously low levels. Even so, there is evidence of residual impairment of central nervous system function after ascents to extreme altitude, and maximal oxygen consumption falls precipitously above 7000 m. The term 'acclimatization' is probably not appropriate for altitudes above 8000 m, because the body steadily deteriorates at these altitudes. Tolerance to extreme altitude is critically dependent on barometric pressure, and even seasonal changes in pressure probably affect climbing performance near the summit of Mt Everest. Supplementary oxygen always improves exercise tolerance at extreme altitudes, and rescue oxygen should be available on climbing expeditions to 8000 m peaks.
Even after short spaceflights, most astronauts experience at least some postflight reduction of orthostatic tolerance; this problem is severe in some subjects. The mechanisms leading to postflight orthostatic intolerance are not well-established, but have traditionally been thought to include the following: changes in leg hemodynamics, alterations in baroreceptor reflex gain, decreases in exercise tolerance and aerobic fitness, hypovolemia, and altered sensitivity of beta-adrenergic receptors in the periphery. Recent studies have demonstrated that signals from vestibular otolith organs play an important role in regulating blood pressure during changes in posture in a 1-g environment. Because spaceflight results in plastic changes in the vestibular otolith organs and in the processing of inputs from otolith receptors, it is possible that another contributing factor to postflight orthostatic hypotension is alterations in the gain of vestibular influences on cardiovascular control. Preliminary data support this hypothesis, although controlled studies will be required to determine the relationship between changes in the vestibular system and orthostatic hypotension following exposure to microgravity. Copyright 1998 Elsevier Science B.V.
The effects of diminished orthostatic and exercise tolerance resulting from prolonged bedrest were studied by noninvasion methods to determine if alterations in myocardial contractility were induced by bedrest. These methods were apexcardiography, systolic time intervals, and echocardiography. It is concluded that bedrest causes detrimental alterations in the contractile state of the myocardium which accounts for the decreases in maximal oxygen uptaken during exercise after bedrest. Tabulated test data are included.
Decreased peak oxygen consumption (VO2pk) and an elevated exercise heart rate (HR) response are associated with a reduction in plasma volume (PV) after space flight and bed rest, a space flight analog. Reduced VO2pk and submaximal exercise tolerance would negatively impact an astronaut s ability to perform near maximal work that would be required in the event of an emergency. We previously have administered IV furosemide followed by a low salt diet to model PV loss and orthostatic intolerance observed after spaceflight. Purpose: To determine whether a pharmacologically-induced reduction in PV results in decreased VO2pk and elevated exercise HR response. Methods: Six subjects (5M, 1F) performed two graded peak cycle tests (work rate increased by 35 or 50 W every 3 min), once while normovolemic and once while hypovolemic. HR and expired respiratory gases were continuously measured. To induce hypovolemia, subjects were administered a single dose of IV furosemide (0.5 mg.kg-1) 30 hr before exercise testing and then consumed a low-salt diet (10 mEq.d(sup -1)). PV was measured using carbon monoxide rebreathing. Exercise HR and VO2 responses were quantified as the area under the curve (AUC) calculated over each quartile of the peak test, based on test time in the hypovolemia condition. Paired t-tests were used to test for differences in PV, VO2pk, and peak HR between conditions. Repeated-measures ANOVAs were used to test for differences in AUC between conditions. Results: PV (3.32+/-0.12 vs. 2.77+/-0.16 L, p<0.05) and VO2pk (3.30+/-0.67 vs. 2.90+/-0.57 L.min(sup -1), p<0.05) were lower during hypovolemia than during normovolemia, but peak HR was not different (187+/-5 vs. 187+/-5 bpm). The AUC for VO2 and HR was different (p<0.05) between conditions only in the highest quartile: HR was 4% higher and VO2 was 5% lower during the hypovolemia condition. Conclusion: The mean difference in VO2pk (-12%) between normovolemia and hypovolemia was similar to the mean difference in PV (-17%). Similar decreases in PV and VO2pk have been observed following short duration space flight, suggesting that pharmacologically-induced PV loss can be used to model microgravity-induced reductions in VO2pk.
Heart rate spectral data obtained for 10 male subjects between 35-49 years following orthostatic tolerance testing with lower body negative pressure prebed rest and after 7-10 days of bed rest, while on placebo and after intravenous atropine are analyzed. Comparison of the spectral atropine rms for subjects prebed rest and after bed rest reveal a decrease from 63 + or - 24 ms to 40 + or - 23 ms. It is observed that heart rate interval variability for subjects after bed rest and with atropine is reduced; the heart rate at bed rest with atropine is increased from 70.4 + or - 12.4 beats/min prebed rest to 83.7 + or - 18.9 beats/min; and the exercise tolerance time for subjects in the atropine prebed-rest phase (658 + or - 352 s) is higher than the bed-rest phase (505 + or - 252 s). It is noted that bed rest impairs the cardiovascular capacity to adaptively modulate physiological responses, atropine exposes bed-rest deconditioning effects, and spectral analysis is useful for studying the effects of bed-rest deconditioning on cardiac dynamics.
Weightlessness effects on physiological systems are summarized, including cardiovascular responses, hematological effects, work capacity (exercise tolerance), respiratory responses, skeletal responses, neuromuscular changes, vestibular responses, metabolism, endocrine and electrolyte responses, and weight loss. The nature of the adaptive response to space flight and microbial changes are also discussed. The effects of zero gravity upon performance are ascertained, and the physiological effects of weightlessness are counteracted.